[非球面衍射多焦点人工晶状体植入患者的视觉质量]

He Yong-Qi, Zhang Chun-Fang, Wang Kai-Jie, Zhu Si-Quan

Beijing Tongren Eye Center, Beiing Tongren Hospital, Capital Medical University, Beijing 100730, China.

Zhonghua Yi Xue Za Zhi. 2009 Aug 18;89(31):2175-8.

OBJECTIVE

To evaluate the visual performance of patients with Tecnis ZM900 aspherical diffractive multifocal intraocular lens (MIOL) as compared with aspherical monofocal intraocular lens (IOL).

METHODS

A prospective nonrandomized controlled study was conducted. Consecutively 114 senile cataract patients (114 eyes) received phacoemulsification and IOL implantation, 57 patients (57 eyes) were implanted Tecnis ZM900 MIOL (multifocal group) and 57 patients (57 eyes) were implanted aspherical Tecnis ZA9003 IOL (monofocal group). All patients were assessed at 3 months postoperatively: uncorrected and best corrected visual acuities for distance and near, distance corrected near visual acuity, higher-order aberrations of IOL, modulation transfer function, contrast visual acuity at different contrast levels and different distance (40 cm, 63 cm and 100 cm) and pseudoaccommodation. Patient satisfaction (spectacle independence, photic phenomena and overall satisfaction) was assessed by a questionnaire.

RESULTS

At 3 months post-operation, both uncorrected near visual acuity and distance corrected near visual acuity were significantly better in multifocal group than monofocal group (t = - 7.62, - 9.89, P < 0.05). The accommodative range was (4.74 +/- 1.05) D in multifocal group and (1.65 +/- 0.68) D in monofocal group (P < 0.01). There was no statistically significantly difference between the two groups in IOL higher-order aberration with different pupil sizes (3 mm vs 5 mm). At the distance of 40 cm and 63 cm, visual acuity scores were higher in multifocal group than in monofocal group (P < 0.01). Modulation transfer function was similar in the two groups and there was no statistically significantly difference. The spectacle independence was 85.9% in multifocal group versus 24.6% in the monofocal group (chi2 = 43.46, P < 0.05).

CONCLUSION

Compared with aspherical monofocal IOL, the Tecnis ZM900 aspherical diffractive MIOL not only provided certain pseudoaccommodation with a better useful near visual acuity, but also provided a better quality of vision, resulting in higher levels of spectacle independence and patient satisfaction.

目的

评估Tecnis ZM900非球面衍射多焦点人工晶状体（MIOL）植入患者与非球面单焦点人工晶状体（IOL）植入患者的视觉表现。

方法

进行一项前瞻性非随机对照研究。连续114例老年性白内障患者（114只眼）接受了超声乳化白内障吸除术及IOL植入术，其中57例患者（57只眼）植入Tecnis ZM900 MIOL（多焦点组），57例患者（57只眼）植入非球面Tecnis ZA9003 IOL（单焦点组）。所有患者均在术后3个月进行评估：测量远、近视力的未矫正及最佳矫正视力、距离矫正近视力、IOL的高阶像差、调制传递函数、不同对比度水平及不同距离（40 cm、63 cm和100 cm）下的对比视力以及拟调节功能。通过问卷调查评估患者满意度（无需眼镜情况、光现象及总体满意度）。

结果

术后3个月时，多焦点组的未矫正近视力及距离矫正近视力均显著优于单焦点组（t = - 7.62，- 9.89，P < 0.05）。多焦点组的调节范围为（4.74 ± 1.05）D，单焦点组为（1.65 ± 0.68）D（P < 0.01）。两组不同瞳孔大小（3 mm与5 mm）下IOL的高阶像差无统计学显著差异。在40 cm和63 cm距离处，多焦点组的视力评分高于单焦点组（P < 0.01）。两组的调制传递函数相似，无统计学显著差异。多焦点组的无需眼镜率为85.9%，单焦点组为24.6%（χ2 = 43.46，P < 0.05）。